Search Results (199)

Human Papillomavirus (HPV) infection poses a significant health risk, particularly for high-risk groups such as men who have sex with men (MSM), people living with HIV (PLHIV), and transgender individuals. Despite the availability of effective vaccines, uptake among these groups remains suboptimal due to various social and behavioral barriers (BeSD). A cross-sectional survey was conducted at the Sexually Transmitted Infections (STIs) clinic in Bologna, Italy, from 8 April to 12 April 2024 using a paper questionnaire, investigating HPV vaccine uptake and BeSD factors influencing vaccination decisions. Statistical analyses included descriptive statistics and multivariate logistic regression. Among the 236 respondents, PLHIV and transgender individuals demonstrated lower uptake rates (60.0% and 15.6%) if compared to women under 30 years old (72.7%). Concern about HPV infection varied significantly across groups, with MSM showing the highest worry (48.7%). Perceptions of vaccine safety and access were mixed, influencing vaccination decisions. Multivariate analysis indicated that age inversely correlated with infection worry (OR: 0.94, 95% CI: 0.91–0.98), while being a woman under 30 (OR: 164.0, 95% CI: 17.2–1560.18) or MSM (OR: 3.53, 95% CI: 1.37–9.11) was positively associated with vaccine uptake. The study identifies disparities in HPV vaccine uptake among STI clinic users in Bologna, Italy, emphasizing the need for targeted public health campaigns. These campaigns could engage STI clinics and address awareness, safety perceptions, and access barriers to enhance vaccination coverage among sexual and gender minorities. Full article

Background/Objectives: Lesbian, gay, bisexual, and transgender (LGBT) individuals often face discrimination in healthcare settings, resulting in health disparities. Evaluating healthcare professionals’ affirmative practices is essential for promoting inclusive care and addressing these disparities. The aim of this study was to assess the psychometric properties of the Spanish version of the Gay Affirmative Practice Scale (GAP-ES), which measures healthcare professionals’ affirmative practices towards gay individuals. Methods: Before assessing its psychometric properties, the original Gay Affirmative Practice Scale (GAP) was translated and culturally adapted from English to Spanish. Following the translation, the psychometric properties were tested on a sample of 236 healthcare professionals. The internal consistency of the questionnaire was measured using Cronbach’s alpha and the discriminatory power index. Factor structure was evaluated with Confirmatory Factor Analysis (CFA) using the Diagonally Weighted Least Squares method. Results: The sample consisted of 152 female (64.41%) and 84 male (35.59%) participants, with 58.05% identifying as heterosexual, 28.81% as homosexual, and 13.14% as bisexual. The internal consistency of the GAP-ES was strong, with Cronbach’s alpha values of 0.915 for the Beliefs subscale and 0.902 for the Behaviors subscale. The McDonald’s Omega coefficient was 0.942, indicating high reliability. CFA confirmed a two-factor structure with satisfactory fit indices (CFI = 0.999, RMSEA = 0.071). Conclusions: The GAP-ES demonstrates strong internal consistency and a stable factor structure. It is a reliable tool for evaluating affirmative practices toward LGBT patients in Spanish-speaking healthcare contexts, supporting improved care for this population. The integration of the GAP-ES into clinical practice and training programs may support the enhancement of cultural competence among healthcare professionals, contributing to the reduction of health disparities for LGBT patients in Spanish-speaking settings. Full article

Introduction: Currently, progesterone is notably absent from conventional feminizing hormone therapies for transgender women. Anecdotal reports indicate the potential for health advantages following the incorporation of progesterone into treatment regimens. The primarily female hormone, progesterone naturally surges in women during the menstrual luteal phase. When administered exogenously, it may expedite bodily changes that are pivotal for gender transition. Progesterone holds promise as a potential remedy for various health conditions prevalent in the transgender woman population. Methods: This narrative review synthesizes existing literature and presents a comprehensive account of the administration of exogenous progesterone in transgender women. A literature search was conducted using the PubMed, Embase, ScienceDirect, and ResearchGate databases. The following keywords were used in the search: progesterone, transgender, breast neoplasms, lactation, prostate, testicular neoplasms, and thrombosis. These terms were combined using Boolean operators. The results of the initial search were screened by three independent reviewers based on their relevance to the topic under study. Results: A total of 104 studies were initially identified as meeting the criteria for inclusion. Following an assessment based on the contents of the title, abstract, and full text, 39 studies were deemed eligible for inclusion. A critical examination of health outcomes was conducted across key sections, including breast development, mental health, lactation, cancer risk (breast and prostate), thrombosis, and nervous and other systems. Discussion: The use of progesterone in the transgender woman population is a topic that has yet to be sufficiently researched. The limited sample size, short follow-up periods, and lack of randomization restrict the potential for achieving a robust scientific evidence base. In order to gain a fuller understanding of this topic, findings from studies on contraception, hormone replacement therapy, and animal models were considered. Conclusions: Progesterone may have a beneficial effect on the bodies of transgender women without significant adverse health effects. Further investigation through well-designed studies is recommended. Randomized controlled trials that include various dosages, broad and long-term effects, and precise demographics are needed. There is an immediate need for more knowledge to create appropriate patent and clinical practice guidelines. Full article

Background/Objectives In recent years, the national Gender Identity Service for individuals under 18 years of age in Denmark has seen a considerable increase in referrals of youngsters during puberty. Given this development, it is important to deepen our understanding of the characteristics of contemporary youngsters seeking help for gender incongruence. This understanding can serve as the foundation for improving current treatment regimens by ensuring optimal individual assessment and care. In this study, we aim to describe the sociodemographic characteristics, health profiles, and treatment trajectories in detail, as well as any changes in these characteristics, of all transgender and gender-diverse youngsters referred to the Gender Identity Service in Denmark from 2016 through 2022. Methods: This is a retrospective observational study of a national cohort comprising all individuals under 18 years of age referred to the Danish Gender Identity Service from 1 January 2016 to 1 January 2023. We will use data from medical records obtained at routine visits from the first assessment through repeated visits. Data on demographics, physical and mental health profiles, and information regarding gender identity will be collected and analyzed. The characteristics of those individuals who progressed to hormone therapy will be compared to those who did not. Results: This study aims to enhance our understanding of the characteristics and needs of contemporary youngsters with gender identity issues. Conclusions: The scientific evidence for the assessment and treatment of gender incongruence in youngsters is limited. The characteristics of youngsters seeking healthcare for gender incongruence today may differ from earlier. Full article

The Northern Triangle countries, including El Salvador, Guatemala, and Honduras, are sources of a significant number of asylum seekers in the United States today. This article examines the underlying societal dynamics in these countries and considers the typical profile of transgender immigrant women seeking asylum in the U.S. on the legal grounds of having faced gender-based violence in their countries of origin. It analyzes the relevant international conventions as well as the social determinants of the health and mental health of transgender asylum seekers. It draws from 35 cases of transgender immigrant women subjected to child sexual abuse; sexual assault, including assault by police; and forced sex work; it reviews examples from the academic and gray literature, including a precedent-setting case heard before the Inter-American Court on Human Rights. It discusses the implications for social science professionals, including the role of experts of country conditions. It provides guidance for immigrant service providers and advocates, particularly the importance of gender-affirming policies and healthcare to this population deserving of protection. Full article

Latin transgender and gender-diverse (LTGGD) individuals experienced the public health measures mandated during the COVID-19 pandemic in unique ways. Intersecting ethnic and gender-identifying frameworks contributes to differing access, support, and well-being observations. The aim of this study was to examine emerging adult LTGGD individuals’ perceptions of their health and well-being experiences during the COVID-19 pandemic in South Florida. Interviews were conducted with nine self-identifying LTGGD individuals. Using a thematic analysis, a total of three major themes were identified as shaping the participants’ experiences and perceptions of health during COVID-19, including (a) healthcare interactions, (b) challenges, and (c) opportunities. Some of the participants were mixed in their perceptions of their well-being during the COVID-19 pandemic; negative concerns included the inability to access general and transgender/gender-diverse specific health services. However, others note that they were happy that the pandemic allowed them to avoid contexts where they regularly experienced microaggressions due to their identities. Additionally, various participants were able to use this time of isolation to identify providers with greater knowledge about LTGGD health needs. These findings highlight the importance of providing culturally competent and humility-centered skills to healthcare providers and others supporting the LTGGD population’s well-being. Full article

Introduction: Collegiate mental health continues to be a worrisome public health concern among college students in the U.S. The unprecedented COVID-19 pandemic has caused an upward trend of mental health crises, especially among lesbian, gay, bisexual, and transgender (LGBTQ+) college students. The objective of this study was to assess the mental health statuses, attitudes towards disease control and mitigation measures, and coping strategies among this vulnerable group. Methods: A web-based survey was conducted at a medium-sized public university in the mid-Atlantic region during the summer and fall of 2021 when COVID-19 was still a major public health concern. The survey was distributed through the listservs of the college and was advertised through campus-wide social media. Descriptive and inferential statistics including a t-test for the differences in group means and a logit regression model for comparing the groups were used. Results: Our final sample is composed of 611 students with 79% of the respondents identifying as straight, and 20% in the LGBTQ+ group. Our results showed that LGBTQ+ students exhibited higher levels of anxiety and fear compared to the non-LGBTQ+ groups. Also, a large proportion of LGBTQ+ students were negatively impacted by the pandemic as compared to the non-LGBTQ+ groups (p = 0.05), while they generally have more positive views on the public health measures to alleviate the adverse impacts from COVID-19 (p = 0.001). Conclusions: Public health emergency management should adopt appropriate strategies and adapt their services to support the mental health needs of LGBTQ+ students. Our study highlighted the need to design tailored health promotion programs and enhance support systems for LGBTQ+ college students during similar emergencies. Full article

(1) Background: Lesbian, gay, bisexual, transgender, queer and other gender and sexual minority-identified (LGBTQ+) adolescents face mental and physical health disparities compared to their heterosexual and cisgender counterparts. Mindfulness-based interventions (MBIs) may be a potential method to intervene upon health disparities in this population. This pilot study explores the initial acceptability and feasibility, along with the descriptive health changes of an online MBI, Learning to Breathe-Queer (L2B-Q), which was adapted to meet the needs of LGBTQ+ adolescents. (2) Methods: Twenty adolescents completed baseline and post-intervention assessments of mental health, stress-related health behaviors, physical stress, and LGBTQ+ identity indicators. In addition, the adolescents participated in a post-intervention focus group providing qualitative feedback regarding the acceptability of L2B-Q. (3) Results: L2B-Q demonstrated feasible recruitment and assessment retention, acceptability of content with areas for improvement in delivery processes, and safety/tolerability. From baseline to post-intervention, adolescents reported decreased depression and anxiety and improved intuitive eating, physical activity, and LGBTQ+ identity self-awareness with moderate-to-large effects. (4) Conclusions: These findings underscore the need and the benefits of adapted interventions among LGBTQ+ youth. L2B-Q warrants continued optimization and testing within the LGBTQ+ adolescent community. Full article

Background: The radial forearm flap remains the gold standard in phalloplasty in gender-affirming surgery due to its versatility and functional outcome, but the significant donor site morbidity and its impact on daily functioning and aesthetic perception remains understudied. This study provides valuable insights into the mid-term functional and aesthetic outcomes of the forearm in transgender individuals following radial forearm flap phalloplasty using widespread instruments for assessment scoring systems and for the evaluation of postoperative wound healing of surgical interventions in general. Methods: Between January 2013 and March 2018, a total of 47 patients underwent radial phalloplasty at AGAPLESION Markus Hospital, and 20 consented to participate in this cross-sectional, retrospective study evaluating functional and aesthetic outcomes post-radial forearm flap phalloplasty using standardized questionnaires (DASH, POSAS, and SBSES). A univariate median regression of each score was performed to determine the associations with selected variables, and correlation analyses between scores was performed using a nonparametric Spearman rank correlation. Results: Among the 20 participants, the median Quick DASH, DASH functionality, DASH sport and music, and DASH work scores indicated minimal to no functional impairment. Scar evaluations using the PSAS, OSAS, and SBSES scales showed overall patient satisfaction with minimal concerns regarding pigmentation and scar texture. Notably, an increase of 0.27 cm² in wound surface area added one point to the DASH sport and music score (p = 0.037). Statistical analysis also demonstrated a significant correlation between functional and aesthetic assessment scores. Conclusions: The radial forearm phalloplasty donor site, evaluated by the PSAS, OSAS, and SBSES scales, leads to minimal or no functional impairment; however, the worsening of the DASH sport and music score with increasing wound surface reflects a direct relation between wound size and functional impairment. Full article

The term “Transgender” is used to describe individuals whose gender identity is different from their external sexual anatomy at birth. The number of people identifying as transgender has increased in recent years, and consequently, the number of gender affirmation surgeries and the use of hormonal therapies has also increased. A wide range of hormonal therapies has emerged considering the target population, age, and final outcomes, and as such these are becoming increasingly developed and complex in order to be the most appropriate for each individual. However, the side effects of these therapies remain to be fully understood. Therefore, this review aims to assess the impact of hormone therapy, in both transgender men and women of different ages, on the lipid profile. From the studies analyzed, it is possible to conclude that there is a relationship between hormone therapy and the lipid profile, with different outcomes between transgender men and women. There is a reduction in cardiovascular risk for transgender women as opposed to transgender men, in whom cardiovascular risk seems to increase due to lipid changes. It is now necessary to understand the mechanisms involved in order to reduce the consequences of these therapies and promote positive health outcomes. Full article

Background/Objectives: The current gender-specific nutritional assessment methods for the transgender population may not cover the unique physiological characteristics of the gender transition process. Considering the potential effects of hormone therapy (HT), it has become relevant to review current evidence on the nutritional status of the transgender population. This systematic review aims to provide an updated report of the characteristics of the nutritional status, including food habits, and eating disorders in transgender individuals undergoing HT. Methods: Five databases were researched (PubMed, Web of Science, Scopus, Scielo, and Cochrane Library) from database inception to May 2024. The PRISMA 2020 statement was used. Studies focusing on adult transgender individuals (18 to 65 years old) that included outcomes related to nutritional status, HT, and food habits were considered for this review. The NOS and NIH tools were chosen to perform the risk of bias and quality assessment. Results: A total of 122 studies were identified, and 27 were included in this review. These studies comprised sixteen cohorts, seven cross-sectional, and four case studies, with a combined number of 8827 participants. BMI was the most referenced parameter, varying between low weight and overweight. High food insecurity frequency, restricted eating behaviors, high fat intake, and low levels of vegetable, grain, and fruit consumption were also observed. Conclusions: While nutritional status was perceived as a relevant factor when administering HT, the relationship between HT with both nutritional status and food habits has been insufficiently explored and warrants further research. Full article

In this paper, we discuss qualitative findings drawn from a larger community-engaged project in a predominantly Black Midwestern city. Data collection for the project, which focused on the effects of policing on the city’s African American community, was carried out in collaboration with Black community organizations and an independent police oversight board. Using an intersectional queer politics lens, we present findings from a thematic analysis of field observations that focused on the city’s LGBTQI+ community. Major themes that emerged include the social context of Black LGBTQI+ oppression, the criminalization of the Black LGBTQI+ body, and mental health impact of policing experiences. Overall, we found that transgender and gender non-conforming experiences with police were particularly harmful. We conclude with insights into the strategies of resilience and resistance used by the community to navigate the impact police work has on their lived experience. Policy implications of our findings and the importance of queer politics to enable Black LGBTQI+ populations to access services and thrive, rather than survive are also addressed. Full article

Transgender and gender-diverse (TGD) individuals continue to experience harassment and discrimination across various aspects of life, significantly impacting their physical and mental health. The scarcity of data on their general health, particularly regarding dietary habits, remains a challenge in developing effective healthcare strategies for this population. To address this gap, we analyzed selected dietary habits, physical activity (PA), and body mass index (BMI) among Italian TGD adults compared to the Italian general population (IGP). An online anonymous survey was conducted via the Computer Assisted Web Interviewing technique from June 2020 to June 2021. Participants were enrolled through clinical centers and TGD organizations. Data from 959 TGD adults were analyzed using chi-squared tests and logistic regression models. Key findings indicated that approximately 70% of TGD individuals consumed fewer servings of fruit and vegetables (FV) than recommended (five or more servings per day). Although red meat consumption was lower overall, a greater percentage of TGD individuals reported consuming more than three servings per week. Additionally, 58% of TGD participants indicated that they did not engage in any PA, compared to 36% of the IGP. Notably, significant differences in BMI were identified, with higher rates of overweight and obesity among TGD individuals assigned female at birth. These results underscore the urgent need for tailored nutritional guidelines and inclusive public health strategies to meet the specific health needs of the Italian TGD population. Expanding access to targeted interventions could contribute to improving overall well-being in this marginalized group. Full article

Social media is used by many Transgender and Gender-Diverse (TGD) people to access queer communities and social support. However, TGD users are also at a higher risk of online harassment than their cisgender peers. There are few studies which explore the role that social media plays in TGD people’s lives. In this study, a qualitative online survey examining online experiences was completed by 52 TGD participants, and the data were analysed using deductive template analysis. The results identified that online communities provided spaces within which participants could experience community-specific support, the validation of their identities, and find much-needed healthcare information. However, the use of social media also exposed participants to transphobia, and the participants described both proactive protective and reactive mitigation behaviours used to deal with these. Key findings highlight the pivotal role that online communities can have for improving wellbeing but also the potential for unintended exposure to transphobia through these communities. The importance of improving online moderation/reporting tools to combat harassment is discussed, as is the need to develop accessible information resources for healthcare professionals so that they may better provide support for TGD patients. Full article

This review aims to analyze the evidence related to violence perpetrated against transgender individuals in health services based on their narratives. This is a systematic literature review of qualitative studies. A search was carried out in the Scopus, Web of Science, Latin American and Caribbean Literature in Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, and MEDLINE databases using the descriptors “transgender people”, “violence”, and “health services”. The eligibility criteria included original qualitative articles addressing the research question, with fully available text, reporting violence specifically by health workers, involving trans individuals aged 18 and above, and published in Portuguese, English, or Spanish. In addition, studies were included that reported experiences of violence suffered by the trans population, through their narratives, in health services. A total of 3477 studies were found, of which 25 were included for analysis. The results highlighted situations such as refusal of service; resistance to the use of social names and pronouns; barriers to accessing health services; discrimination and stigma; insensitivity of health workers; lack of specialized care and professional preparedness; and a system focused on binarism. The analysis of the studies listed in this review highlights the multiple facets of institutional violence faced by the transgender population in health services. It is evident that the forms of violence often interlink and reinforce each other, creating a hostile environment for the transgender population in health services. Thus, there is an urgent need to create strategies that ensure access to dignified and respectful care for all individuals, regardless of their gender identity. Full article